Microvascular Reconstruction

An Established Field

A 1993 research paper described microvascular surgery as “A new frontier in head and neck reconstruction, surgery that was previously unattainable.”

As the video suggests, whilst still a complex, specialist task, a further three decades have seen the procedure become widely accepted. A route to excellent functional and aesthetic outcomes.

New imaging technology has played a part, along with research and sharing of information amongst leaders in the field. Also the development of fine, micro-surgical instruments and techniques for their use.

Microvascular reconstruction can apply to a range of tissues and medical conditions. Following the removal of a facial tumour, an accident, or to reattach severed areas, such as an ear.

The predominant use is to cover tissue loss, from the skin to greater depth, using a patient’s own body to provide a well matched, naturally accepted replacement.

Reconstructive Techniques

Whilst other areas such as nerves can be involved, as the name suggests, microvascular reconstruction surgery is predominantly about blood vessels.

They can be isolated by type, in the donor and recipient areas, to identify correct association with skin, fat, muscle or bone. The structure required is then transplanted in conjunction with the appropriate blood vessels.

If a case arises where an additional vein is required for a new connection, this can be taken from your arm, or leg, via a small incision. Transferring blood vessels with the transplanted tissue is still the focus.

This helps to keep the tissue alive after reconstruction. An advantage to any organic transplant, similar to bringing the roots along when a plant is moved, although with greater precision and care.

Microvascular surgery is carried out using a specialised operating microscope, ideal for the very thin sutures (stitches) used to rejoin blood vessels.

A Well Planned Procedure

Your consultant will have reviewed your medical and surgical history. Any tests carried out, such as an ECG, x-rays, or blood tests will have been studied, complex cases can include a 3D simulation, or model.

The venue will be well suited and anaesthetic procedures organised, to ensure pain free surgery. A detailed surgical plan will help to ensure you benefit from the fact that in reconstruction, the safest tissue is your own.

Whilst transplant techniques from one person to another are available, there can be a risk of rejection, or a need to take immune-suppressing medication. Not the case when your own tissue is simply growing elsewhere.

Modern microvascular surgery is miraculous in a sense but still reliant on planning, skill and understanding. If we can answer any further questions on a key maxillofacial treatment, please get in touch.